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General NPI Number Information
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NPI Number | 1518068329
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Entity Type | Individual
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Provider Name | NEIL THOMAS SHMUNES M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3316 THIRD STREET SOUTH SUITE 103
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250
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Country | US
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Telephone | 904-241-7865
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Fax |
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Provider Business Mailing Address
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Address Line | 152 UNIVERSITY BOULEVARD NORTH
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City | JACKSONVILLE
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State | FL
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Zip | 32211
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Country | US
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Telephone | 904-725-2185
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 047073
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 024091
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License Number State | GA
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